Diseases A-Z: Rheumatoid arthritis

Several years ago, my friend Lynne developed difficulty using her hands. This was particularly alarming to her since she relies on her hands in her job as a nurse anesthetist. After some uncertainty, she was diagnosed with rheumatoid arthritis.

"Arthritis" is a general term meaning inflammation of the joints without specifying the cause. Lupus, gout, Lyme disease, even psoriasis can all cause arthritis.

Rheumatoid arthritis is a specific disease. It is an autoimmune disease, where -- for unknown reasons -- the immune system attacks and destroys joint linings. Like many autoimmune diseases, it most often affects middle-age females.

Frequently the hands are involved, resulting in painful swollen knuckles and fingers deviating to the pinkie side. Other joints, such as elbows, knees, ankles and hips, often are also involved. Advanced arthritis can be totally disabling.

Rheumatoid arthritis does not affect just the joints. It can cause fatigue and fever, skin nodules, anemia, heart disease, lung disease and even eye problems.

There is no cure, and managing the disease is more art than science. It is treated aggressively as soon as the diagnosis is made. Nonsteroidal medicines and steroids play a role, but more potent "disease-modifying" agents usually are needed.

A new class of drugs, the so-called "biologic" agents, often are extremely effective, but they are expensive and also make the patient vulnerable to serious infections.

My friend Lynne continues to struggle with rheumatoid arthritis but, thanks to one of the newer medications, is still able to work. In spite of her arthritis, her patients are in good hands.